US embassy cable - 05DJIBOUTI283

UNCLAS DJIBOUTI 000283 
 
SIPDIS 
 
STATE FOR AF AND AF/E 
STATE ALSO PASS USAID 
 
E.O. 12958: N/A 
TAGS: PREL, EAID, SOCI, DJ 
SUBJECT:  LAUNCH OF HEALTH DONOR-COORDINATING GROUP IN 
DJIBOUTI 
 
 
1. U) A launching ceremony took place March 14 at the Ministry of 
Foreign Affairs, to inaugurate a new donor-coordinating group in 
health in Djibouti and to formally announce to the public that 
both donors and the Ministry of Health are ready to work together 
to help the people of Djibouti.  Focus of the coordination is 
expected to be on activities of donor agencies and the Ministry 
of Health as well as other international organizations such as 
those of the United Nations. 
 
2. (U) The intent of the coordinating group, as originally proposed 
by Ambassador Ragsdale and USAID Representative Schulman, is to 
coordinate the activities of both donors and the Ministry of Health. 
The aim is to insure that resources are used without duplication of 
effort, and to assist the Ministry of Health achieve its goals as 
laid out in the Ministry's National Health Strategic Plan. 
 
3. (U) The ceremony was opened by Minister of Health Dr. Mohamed Ali 
Kamil, who welcomed everyone and emphasized the importance of all 
Donors working together, in coordination with the Ministry of Health, 
to assist the government and people of Djibouti to have both better 
access and quality of services.  He said the aim would be to reduce 
morbidity and mortality. 
 
4. (U) WHO representative, Dr. Jihan Tawilah, whose remarks followed, 
stressed that in addition to the importance of donor coordination in 
financing reform of the health sector, donors should also coordinate 
and work with the Ministry of Health to identify more clearly what 
needs to be done and how to go about it. She cited the example of the 
need to develop human resources to be able to provide services to the 
population, pointing out that the issue is more complicated than just 
putting money toward training, but also involved identifying what kind 
and levels of cadres are needed, and how potential candidates would be 
found. 
 
 5. (U) The U.S. and French Ambassadors make brief presentations 
highlighting the need to support health reform in Djibouti and 
outlining what their respective governments were doing to assist the 
Ministry of Health to achieve its goals and objectives.  In her 
remarks, Ambassador Ragsdale also cited needed efforts in addressing 
challenging Issues such as HIV/AIDS, and pointed out that the US 
government was Intending to provide more resources to address this 
epidemic in Djibouti. 
 
6. (U) During the main part of the agenda, Dr. Saleh Banoita, the 
Secretary General for the Ministry of Health, presented an outline 
 
SIPDIS 
of the National Plan of Action for the Ministry of Health, briefly 
discussing the five main objectives of this plan, in addition to 
several activeties associated with each objective. Ali Sillaye, 
Director of Program Management in the Ministry of Health, followed 
with a presentation of the level of donor investment in health in 
Djibouti, showing a breakdown of the different donors, the specific 
areas of program support and the amount being funded.  Next, Thomas 
Davin, the Acting Representative of UNICEF, spoke on behalf of both 
UNICEF and WHO concerning the Millennium Development Goals and where 
Djibouti was at this point in time with regard to year 2015 targets. 
He presented draft tables indicating that Djibouti, although making 
some headway, still had work to do in order to achieve the targets 
by 2015. Finally, Abdourahman, Director of Training and 
Cooperation at the Ministry of Health, presented the terms of 
reference for the operation of the "donor coordination committee" 
including the core group and its ad hoc committees, as well as the 
larger body, which was present at this ceremony. 
 
7. (U) Overall, it was agreed that several areas needed to be closely 
monitored and supported by the donors and the Ministry alike including 
financing, development of human resources and working toward achieving 
the Millennium Development Goals in health. It was agreed that ad hoc 
committees should be formed on these topics and the core group would be 
informed of progress of these ad hoc committees. In turn, the core 
group would inform the larger group on a bimonthly basis of overall 
activities and efforts. 
 
8. (U) Comment: Both donors and the Ministry of Health appeared 
committed to helping Djibouti achieve the ambitious goals spelled 
out in the Millennium Development Plan. The Minister of Health made 
it clear that Djibouti has a great deal of work to do in order to meet 
these challenging goals and must have the maximum effort of the donors 
and Ministry staff in order to achieve them. Donors voiced their desire 
to assist the Ministry on specific details and to insure that their 
efforts would maximize their financial support. Concern for the long 
term was raised by USAID Representative, who asked the Minister of 
Health how much of the National budget went to health.  His reply of 
less than 5%, and his assessment that more support was needed, raised 
donor concerns about sustainability.  End comment. 
RAGSDALE